Head and Neck Cancer Care

 Symptoms and signs can occur even when no cancer is present. Many times complaints will be due to some other condition. But you won't know without an examination, so if they do occur, see your doctor to be sure.

• A lump in the neck: Cancers that begin in the head or neck usually spread to lymph nodes in the neck before they spread elsewhere. A lump in the neck that lasts more than two weeks should see a physician as soon as possible. Of course, not all lumps are cancer. But a lump (or lumps) in the neck can be the first sign of cancer of the mouth, throat, voicebox (larynx), thyroid gland, or of certain lymphomas or blood cancers. Such lumps are generally painless and continue to enlarge steadily. 
• Change in the voice: Most cancers in the larynx cause some change in voice. Any hoarseness or other voice change lasting more than two weeks should alert you to see your physician. An otolaryngologist is a head and neck specialist who can examine your vocal cords easily and painlessly. Most voice changes are not caused by cancer, you shouldn't take chances. If you are hoarse for over two weeks, ensure you don't have larynx cancer; See your doctor. 
• A growth in the mouth: Most cancers of the mouth or tongue cause a sore or swelling that doesn't go away. These sores and swellings may be painless unless they become infected. Bleeding may occur, but often not until late in the disease. If an ulcer or swelling is accompanied by lumps in the neck, be very concerned. Your dentist or doctor can determine if a biopsy (tissue sample test) is needed and can refer you to a head and neck surgeon to perform this procedure. 
• Bringing up blood: This is often caused by something other than cancer. However, tumors in the nose, mouth, throat, or lungs can cause bleeding. If blood appears in your saliva or phlegm for more than a few days, you should see your physician. 
• Swallowing problems: Cancer of the throat or esophagus (swallowing tube) may make swallowing solid foods difficult. Sometimes liquids can be troublesome, and food may "stick" at a certain point before passing through to the stomach or coming back up. If you have trouble almost every time you try to swallow something, you should be examined by a physician. Usually, a barium swallow x-ray or an esophagoscopy (direct examination of the swallowing tube with a telescope) will be performed to find the cause. 
• Changes in the skin: The most common head and neck cancer is basal cell cancer of the skin. Fortunately, this is rarely a major problem if treated early. Basal cell cancers appear most often on sun-exposed areas like the forehead, face, and ears, although they can occur almost anywhere on the skin. Basal cell cancer often begins as a small, pale patch that enlarges slowly, producing a central "dimple" and eventually an ulcer. Parts of the ulcer may heal, but the major portion remains ulcerated. Some basal cell cancers show color changes. Other kinds of cancer, including squamous cell cancer and malignant melanoma, also occur on the skin of the head and neck. Most squamous cell cancers occur on the lower lip and ear. They may look like basal cell cancers and, if caught early and properly treated, usually are not much more dangerous. If there is a sore on the lip, lower face, or ear that does not heal, consult a physician. Malignant melanoma classically produces dense blue-black or black discolorations of the skin. However, any mole that changes size, color or begins to bleed may be trouble. A black or blue-black spot on the face or neck, particularly if it changes size or shape, should be seen as soon as possible by a dermatologist or other physician.
• Persistent Earache: Constant pain in or around the ear when you swallow can be a sign of infection or tumor growth in the throat. This is particularly serious if it is associated with difficulty in swallowing, hoarseness, or a lump in the neck. These symptoms are best evaluated by an otolaryngologist.